| NPI | 1689014334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA FOWLER Managing Member 817-441-2266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX M9285) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |