NPI | 1861677700 |
---|---|
Entity Type | Organization |
Authorized Contact | SHELLY SHEA Enrollment Specialist 817-484-6274 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K0107) |
Enumeration Date | 2008-01-09 |
Last Update Date | 2020-11-06 |