| NPI | 1497262992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNES DELEAWE Nurse Practitioner 817-680-8148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP122583) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |