| NPI | 1053358267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY A MORA Billing 806-242-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-12 |