| NPI | 1982417077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYLYN MARIE HILLIARD Authorized Official 817-973-5331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0000X | |
| 225100000X Physical Therapist | |
| 2251G0304X Physical Therapist, Geriatrics | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-06-02 |