| NPI | 1174871313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HUI Member 817-683-7115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 26525) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25689) |
| 1223G0001X Dentist, General Practice (Licence: TX 26525) | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 25689) | |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2015-07-20 |