| NPI | 1013455443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMID GHALAMBOR Owner 972-872-8408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX Q7044) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q7044) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX Q7044) | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2019-02-05 |