| NPI | 1659446409 |
|---|---|
| Doing Business As | CLINIC |
| Entity Type | Organization |
| Authorized Contact | RONALD JEFFREY WASHINGTON Owner Administrator 214-948-7783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX E1172) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2023-09-06 |