| NPI | 1457101206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE T SERNA Administrator 817-313-5597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-03-25 |