| NPI | 1972327203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRACE VP Compliance & Hr 469-607-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2025-06-10 |