| NPI | 1629451117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON M BRYANT CEO 214-662-0673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 802187487) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |