| NPI | 1649384884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN YVONNE HACKNEY Billing Manager 817-800-8386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 544119) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |