| NPI | 1588379739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY WU Director 214-659-1503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261Q00000X |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-03-15 |