| NPI | 1679949424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TY BURGESS Authorized Official 469-930-4305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N2137) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |