| NPI | 1598163271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA WATERS Owner/Administrator 469-337-5415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX 016509) |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2014-12-12 |