| NPI | 1407808652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE A RICHEY Business Administrator 817-336-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2011-06-13 |