| NPI | 1922093061 |
|---|---|
| Doing Business As | TROPHY CLUB FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | LAINEY GEE Business Manager 817-430-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2007-10-31 |