| NPI | 1396025102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL G FISHER Owner 817-545-1355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX G9453) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2014-10-08 |