| NPI | 1194260646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WILCOX Secretary 1915-534-1051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX 657839) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX 657839) |
| 208800000X Urology (Licence: TX 657839) | |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2016-12-19 |