| NPI | 1104174945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN E STOOS Owner 817-516-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |