| NPI | 1396038238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELTON WAYNE BAZZLE CEO 214-698-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-05-26 |