| NPI | 1477226082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUBUKOLA T AMUDIPE Medical Director 817-440-4247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2022-02-07 |