| NPI | 1972709533 |
|---|---|
| Doing Business As | AVENUE 360 HEALTH AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JUDITH PRAPTA Office Manager 817-303-0496 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX K6434) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2021-10-05 |