| NPI | 1619276466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCIS DEKU President 817-226-8759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 00966) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: TX 00966) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-30 |