| NPI | 1396097945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVAS GURRAM REDDY President 817-808-3443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2012-10-05 |