| NPI | 1790005734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E. ORTEGA , PAC Owner/Practioner 214-244-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2022-02-24 |