| NPI | 1154454205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB ELLZEY CEO/President 817-444-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 000469) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-11-11 |