| NPI | 1881123909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SUMLER Owner 972-200-0539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TX PA08075) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-07-21 |