| NPI | 1124357249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA SMITH Billing/Credentialing Coordinator 888-737-9615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX 140000) |
| Enumeration Date | 2009-12-19 |
| Last Update Date | 2009-12-19 |