| NPI | 1831788652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JENKS Authorized Official 214-221-2580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2021-01-15 |