| NPI | 1780959361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF HENDERSON Authorized Official 972-401-8720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |