| NPI | 1720108053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE G MOFFETT Administrator 469-362-6543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX K2507) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2009-08-17 |