| NPI | 1396938593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN NELSON INNES Doctor 214-618-2802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX M2658) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |