| NPI | 1851589279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE WISTL Office Manager 214-239-1053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX TSBME-K7949) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2007-10-10 |