| NPI | 1952117251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MARCIANO Partner 817-308-6613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2024-12-10 |