| NPI | 1518689769 | 
|---|---|
| Doing Business As | CENTERWELL SENIOR PRIMARY CARE- SOUTH GARLAND | 
| Entity Type | Organization | 
| Authorized Contact | ANGIE MARTINEZ Senior Credentialing Professional 407-447-7120 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine | 
| Additional Taxonomies | 207Q00000X Family Medicine | 
| 208D00000X General Practice | |
| Enumeration Date | 2022-09-14 | 
| Last Update Date | 2022-10-18 |