| NPI | 1063762912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BOOTHE Owner/Provider 817-303-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX H 6063) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2013-04-03 |