| NPI | 1417107061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL MCDONALD Manager 214-670-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2008-10-20 |