| NPI | 1831583095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA WALDRUM Office Manager 817-377-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX H8725) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |