| NPI | 1093171761 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ALEXANDER T NGUYEN Manager 214-613-1589 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX n5907) | 
| Enumeration Date | 2016-01-11 | 
| Last Update Date | 2018-03-22 |