| NPI | 1013218601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN HEISTEIN Medical Director 817-328-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2010-11-12 |