| NPI | 1023045374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDIC STEPHANIAN President 972-475-6683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 208600000X Surgery |
| 2086S0129X | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2015-08-28 |