| NPI | 1679967145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABA SHABNAM Medical Director / Owner 817-776-0605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M2797) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2021-03-11 |