| NPI | 1942689559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMI MAYORGA DICKSON President 972-712-0591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX ap119548) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2020-07-28 |