| NPI | 1780955708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MALONE Office Manager 817-481-2767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX F4238) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |