| NPI | 1639287451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH SHILLING LIVINGSTONE Owner 817-294-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G5305) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2018-12-10 |