| NPI | 1841288602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTEL DENISE MILLER Billing/Credentialing COO Rdinator 214-426-3645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: TX 130713404) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2020-08-22 |