| NPI | 1619790821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA KAY LOWERY Credentialing Manager 469-930-3077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |