| NPI | 1669727012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA E FERGASON Controller 214-369-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX H8055) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2018-11-30 |