| NPI | 1114186616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRI D WILSON CEO 214-691-1902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX M0918) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology |
| 2085R0001X (Licence: TX K3232) | |
| 2088P0231X Urology, Pediatric Urology (Licence: TX G9345) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2025-08-19 |