| NPI | 1750781035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA ANN GONZALES Owner/Program Director 214-646-7933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2014-08-24 |
| Last Update Date | 2014-08-24 |