| NPI | 1154317394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL P. MARTIN President 817-529-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2009-10-16 |