| NPI | 1104300789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY DEAN SANDERS Surgical First Assistant 817-714-9066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2020-03-28 |