| NPI | 1558331066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADOLPHUS RAY LEWIS Physician/Owner 817-413-0943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2015-05-26 |