NPI | 1578988945 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA FLORES Office Manager 817-496-2343 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 24570) |
Enumeration Date | 2014-02-21 |
Last Update Date | 2014-02-21 |