NPI | 1508193251 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA ANN DOMINGUEZ Insurance Coordinator 214-369-6411 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX D3468) |
Additional Taxonomies | 207Q00000X Family Medicine |
207QG0300X Family Medicine, Geriatric Medicine | |
Enumeration Date | 2009-11-17 |
Last Update Date | 2013-10-29 |