NPI | 1053764779 |
---|---|
Entity Type | Organization |
Authorized Contact | COLLIN LEMASTRIE Officer/Authorized Official 469-250-3640 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2016-07-18 |
Last Update Date | 2024-10-04 |