| NPI | 1407258106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RANDAL SLATER President 817-277-0177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX 14001) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |