| NPI | 1114372588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALITA WATSON Recep/ Credentialing 972-231-3188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 18506) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |