| NPI | 1851721518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WISH MEMA Nurse Practitioner 469-223-9489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TX 742276) |
| Enumeration Date | 2013-11-17 |
| Last Update Date | 2013-11-17 |