| NPI | 1700284056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHONDA TRAYLOR Family Nurse Practitioner 817-209-7736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX F0814245) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |