| NPI | 1609348580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELORIS RENEE HARWELL Pediatric Nurse Practitioner 469-602-5277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2020-03-12 |