| NPI | 1780183442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILYAN BLATT Owner 972-787-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX L8525) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 781962) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2021-08-13 |