| NPI | 1427296912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E WILLIS President 817-498-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX MCH-7354) |
| Additional Taxonomies | 111NR0400X (Licence: TX DC6911) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J0365) | |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-07-27 |