| NPI | 1104104009 |
|---|---|
| Doing Business As | SHADOW CREEK MEDICAL SPECIALTIES |
| Entity Type | Organization |
| Authorized Contact | J ENRIQUE TABARINI Owner 205-617-6672 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX 23794) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-12-15 |