| NPI | 1659082956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHRUF A KHAN Administrator 817-539-6203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2022-12-07 |