| NPI | 1700163060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA L AXMANN President 972-378-0068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX H5417) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |