| NPI | 1396626057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ORTEGA Physician Associate 214-233-3094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2025-09-09 |