| NPI | 1407248982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE ANGEL Named Administrator 469-893-6538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX 736323) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2015-02-20 |