| NPI | 1538229505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASH KANDON Credentialing Manager 972-835-5274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 593583) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2016-01-19 |