| NPI | 1033416870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN L TOWNSEND Owner 512-459-1269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX J4566) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX J4566) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-04-20 |