| NPI | 1871214254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE J TELFORD Managed Care Consultant 469-800-8648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |