| NPI | 1013753953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE E. SMITH Owner 817-806-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2025-07-10 |