| NPI | 1588253678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ALCANTAR Business Manager 817-412-0792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2024-10-03 |