| NPI | 1649788373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHAL PANKAJKUMAR SHAH Medical Director 817-778-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: TX Q5097) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX Q5097) |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2018-01-16 |