| NPI | 1447386966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE ROBERTS Office Staff 972-393-5559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G6149) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02895) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2014-06-05 |