| NPI | 1093230450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BRADFORD Managing Partner 214-738-0357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 289-0) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-08-30 |