| NPI | 1700265873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GONZALO A AILLON Owner 214-943-9406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX D-7730) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-22 |