| NPI | 1871758573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG PODGURECKI Superviser Biller 817-561-4885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F3290) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-11-25 |