| NPI | 1770947160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON TINLEY Principal 682-703-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QC1800X Clinic/Center, Corporate Health |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2016-04-11 |