| NPI | 1831893296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA L. JINGLE Secretary 817-870-2795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2024-07-31 |