| NPI | 1154823201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL FREDERICK Md/Owner 512-485-7208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX L9364) | |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2020-09-11 |