| NPI | 1164441333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIANA PROFFER Physician 806-354-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX K6910) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX K3932) |
| 208200000X Plastic Surgery (Licence: TX M0532) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-07-23 |