| NPI | 1487933347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIBIANA LADINO Provider 972-773-9873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX N3806) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2011-08-10 |