| NPI | 1972864486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANNABEN H NANGHA President 817-477-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TX N8959) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2015-10-13 |