| NPI | 1124552864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MOORE Owner 214-886-9766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00597) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |