| NPI | 1982026480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRIVIDYA SRIDHARA Manager/Owner 972-521-3366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: TX P4113) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2018-07-09 |