| NPI | 1730960501 |
|---|---|
| Former Legal Business Name | HEALTHSOURCE FAMILY & SPORTS MEDICINE/ TAYLIN HEALTH CARE MNGT. |
| Entity Type | Organization |
| Authorized Contact | GREGORY DEWAYNE TAYLOR Clinic Owner 214-941-4903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2023-10-10 |