NPI | 1700055423 |
---|---|
Entity Type | Organization |
Authorized Contact | JUDITH ABIGAIL MOSS Doctor 817-573-8320 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX J6020) |
Enumeration Date | 2008-02-27 |
Last Update Date | 2008-02-27 |