| NPI | 1154956928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN LEMAISTRE Officer / Authorized Official 214-213-0723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2024-09-10 |