| NPI | 1376108944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA MARTIN Owner 972-740-5572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |