| NPI | 1629329529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA RACE Biller/Credentialing 214-500-6366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 584762) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2025-10-01 |