| NPI | 1497057012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO RUBANG DIZON Administrator 972-932-4345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX K2549) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-09 |