| NPI | 1497025621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD ROTAN President 817-905-9996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207N00000X Dermatology | |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2013-02-10 |