| NPI | 1043361587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA GOMEZ Practice Administrator 817-540-7085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: TX 007127) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |