| NPI | 1144748286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DALE HARRIS Member 936-559-3783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2017-09-08 |