| NPI | 1891475026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAGA SAI VENKATA H MADHAVAPEDDI Owner 817-668-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2023-07-21 |
| Last Update Date | 2023-07-24 |