| NPI | 1144331760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN LEMAISTRE Officer/Authorized Official 469-250-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 060068) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-11-15 |