| NPI | 1194115444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY HUBBARD Plastic Surgeon 214-370-4813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: CO 155941) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |