| NPI | 1689955767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANESIA KHVOROFF GARMON President 817-341-7626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E3278) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2011-09-02 |