| NPI | 1467659946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER TRAN Manager 972-406-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX DC7300) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2020-08-22 |