| NPI | 1962872630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY JORDAN VP Of Payer Relations 469-307-5810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M9987) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2016-03-28 |