| NPI | 1912032384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M BULLARD President 817-355-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363AM0700X Physician Assistant, Medical | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-01-20 |