| NPI | 1649457896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY EARL Asst.CEO 817-366-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX 000727201) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |