| NPI | 1043869100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JOHN BROCK Managing Partner 972-979-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |