| NPI | 1952613465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ORTEGA Administrator 214-244-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K5697) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA02353) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2016-09-12 |