| NPI | 1023512282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE LEMOINE MAXWELL Director 214-983-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 225100000X Physical Therapist |
| 363AS0400X Physician Assistant, Surgical | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2025-09-24 |