NPI | 1144481110 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN ANDREW LAURENCE President 817-723-8390 |
Organization Subpart ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA04581) |
Enumeration Date | 2008-06-22 |
Last Update Date | 2008-06-22 |