| NPI | 1689718975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART CHARLES PICKELL Owner 817-732-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX L2552) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-08-22 |