| NPI | 1902419187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DEJESUS CEO 817-751-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| 2251G0304X Physical Therapist, Geriatrics | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 163WH0200X Registered Nurse, Home Health | |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2022-04-19 |