| NPI | 1679983662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CORIA Owner 972-904-5230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2023-06-06 |