| NPI | 1659577138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAPHNE LOUISE FAVROTH Owner 972-669-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H9074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 019205) |
| 208000000X Pediatrics (Licence: TX H9074) | |
| 208000000X Pediatrics (Licence: LA 019205) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2014-03-17 |