| NPI | 1902266539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY DEWAYNE MARTIN Pres 972-789-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX AP123042) |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2020-11-17 |