| NPI | 1861853004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK P. CERISE President & Chief Executive Officer 214-590-8006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 207Q00000X Family Medicine | |
| 213E00000X Podiatrist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2022-12-07 |