| NPI | 1578239877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIT JADEJA COO 817-618-7667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2021-08-18 |