| NPI | 1851774079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SREERAM GONNALAGADDA Owner/Manager 469-850-1432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX q2446) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-10-25 |