NPI | 1548661713 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK ALLEN SANDERS President & CEO 817-713-9162 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K9653) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX K9653) |
207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX K9653) | |
209800000X Legal Medicine (Licence: TX K9653) | |
Enumeration Date | 2014-09-08 |
Last Update Date | 2021-10-18 |