| NPI | 1922736636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE EWUCHIE Physician Assistant 469-867-4239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 251S00000X |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2022-08-10 |