| NPI | 1427415314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN PHAM Managing Member 817-766-7421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2021-01-21 |