| NPI | 1003352840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY MCCARVER President 214-906-2875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX 168736) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |