| NPI | 1578618492 |
|---|---|
| Doing Business As | COOPER STREET MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DOYLE F GALLMAN Physician 817-453-2123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H2931) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |