| NPI | 1831159466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA ROSE COPPOLA Billing Administrator 817-459-5245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2007-07-30 |