| NPI | 1144645995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN TRIPP Practice Manager 817-518-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2020-08-10 |