| NPI | 1134965262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIANA CRAWFORD Office Administrator 682-200-8580 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |