| 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 |