| NPI | 1154830289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GONZALO GONZALES Owner 469-925-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX N6319) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2025-01-29 |