| NPI | 1427336932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEENA MARIE KABETZKE Owner 972-602-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX 5972) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2011-08-01 |