| NPI | 1679763205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BYRNE Owner 817-329-4897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-11-29 |