| NPI | 1982476651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE HARTMAN Authorized Official 817-370-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2023-10-26 |