| NPI | 1104950443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EXLINE MARTIN Owner 972-566-6988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2009-07-22 |