| NPI | 1659695146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM HIGGINS Owner 817-522-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N4471) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX N3995) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX M4379) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX M4379) | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2025-09-10 |