| NPI | 1467633669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI MARIE LUCAS Office Manager 817-346-5266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G8201) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |