| NPI | 1124125604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN LEMAISTRE Officer/Authorized Official 469-250-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: FL 1258) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2024-10-14 |