| NPI | 1568623908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMIE M JACKSON Billing Mgr 469-916-4767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L8111) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |