| NPI | 1063501005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE NEEDHAM Administrator 806-354-8891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: TX ASC061) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-03-11 |