| NPI | 1427348168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL HEDTKE Managing Member 817-891-8356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 675701) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2024-06-26 |