| NPI | 1124508841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN PECK Md 972-503-6863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2020-01-22 |