| NPI | 1992157697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON K CLARKE Medical Director Owner 214-803-4516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F0154) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L4890) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |