| NPI | 1043302243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN STIVERS Business Office 940-322-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX G2792) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX G2792) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2008-06-25 |