| NPI | 1083716187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DAVID YOUNG President/Owner 903-465-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX J0388) |
| 207X00000X Orthopaedic Surgery (Licence: TX J0388) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2011-03-02 |