| NPI | 1023808425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN RAY WYANT Sole Owner 214-714-8603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-20 |