| NPI | 1851687842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY T POSTLE Designated Official 469-744-0237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-11-17 |