| NPI | 1588138143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRISON CLAYPOOLE Manager 214-550-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2022-05-04 |