| NPI | 1366693319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RELDA JEANNE SETLIFF Doctor 214-630-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX G5657-1) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2011-06-17 |