| NPI | 1427059716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY HINSHAW Office Manager 972-276-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX DOE3019) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: TX DOE3019) |
| 302R00000X Health Maintenance Organization (Licence: TX DOE3019) | |
| 305S00000X Point of Service (Licence: TX DOE3019) | |
| 302F00000X Exclusive Provider Organization (Licence: TX D0455) | |
| 302R00000X Health Maintenance Organization (Licence: TX D0455) | |
| 305R00000X Preferred Provider Organization (Licence: TX D0455) | |
| 305S00000X Point of Service (Licence: TX D0455) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2007-12-03 |