| NPI | 1447556618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SISK Member 817-845-4677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX h4424) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2011-02-04 |