| NPI | 1164802385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER HOLMES Owner/Operator 214-304-1228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09735) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |