| NPI | 1134615206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY POPE Manager 817-781-3550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX K0518) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX K0518) | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2025-10-24 |