| NPI | 1609293380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN WALKER Doctor 972-720-9943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX D2622) |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: TX PT1107050) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-28 |