| NPI | 1528330792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHALIA L JACKSON BUTLER CEO 214-277-2243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP117597) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP117597) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP117597) | |
| 363LC1500X Nurse Practitioner, Community Health (Licence: TX AP117597) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: TX AP117597) | |
| 314000000X Skilled Nursing Facility (Licence: TX AP117597) | |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2020-09-28 |