| NPI | 1437811759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSON SMITH Manager 214-893-9722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2021-11-15 |