NPI | 1972652600 |
---|---|
Entity Type | Organization |
Authorized Contact | KIM THOMAS Secretary 972-239-9252 |
Organization Subpart ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2007-01-10 |
Last Update Date | 2025-09-11 |