| NPI | 1790264877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR GREBENNIKOV Owner 972-495-4926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX K9291) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |