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 |