| NPI | 1083853659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAI L GALLOP Administrator 817-348-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX pending) |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-11-25 |