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 |