| NPI | 1083946701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOT G FORTE CEO 214-227-2457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: TX SA00070) |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 1421) | |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2022-06-21 |