| NPI | 1497022834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUDDAMALLE J AUGUSTINE President 817-861-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TX G6261) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |