| NPI | 1760010201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK FRYE Owner 972-358-6526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2022-07-20 |