| NPI | 1558655274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREJE SAHEL AYO President 817-739-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX N0617) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2021-10-11 |