| NPI | 1083947220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER PHELPS Owner 210-710-9509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2012-05-10 |