| NPI | 1104233675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN A BASSICHIS Owner 214-394-8645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: TX 2086) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2016-01-04 |