| NPI | 1710758966 |
|---|---|
| Doing Business As | MAIN STREET MEDICAL |
| Entity Type | Organization |
| Authorized Contact | SHARON MARSHALL Owner 817-739-5848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |