| NPI | 1619616505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS M FOWLER Md/Owner 469-757-2468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2025-10-18 |