| NPI | 1619003886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIDELIS K UNINI Medical Director 817-301-2053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX M5959) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2014-04-16 |