NPI | 1730197286 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT J HENDERSON Medical Director 214-688-0078 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX C1011) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2012-07-10 |