| NPI | 1881122570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKEBA WALLER President/Owner 817-465-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX 42313) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2022-06-08 |