| NPI | 1407314941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA CRETSINGER Practice Manager 214-941-2777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2024-07-18 |