| 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 |