| NPI | 1407375744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANNA VILLARREAL Credentialing Manager 214-295-6703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2022-07-21 |