| NPI | 1154564383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE RAE WILLINGHAM Owner 214-526-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: TX H0463) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-04-17 |