| NPI | 1114700770 |
|---|---|
| Doing Business As | GREAT BASIN VEIN SPECIALISTS |
| Entity Type | Organization |
| Authorized Contact | ANWAR SELASSIE MACK President 832-744-0949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-10-12 |