| NPI | 1033295142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD EARL ICAZA Owner 214-385-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX K9809) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-06-12 |