| NPI | 1720468390 |
|---|---|
| Doing Business As | PVC FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | ZAINABU KOROMA Administrator 972-979-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120628) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L5507) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2021-10-18 |