| NPI | 1154841963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY GARZA Owner 817-294-0934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX M9302) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX M9302) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |