| NPI | 1194984757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WISAM NACHAWATI Physician Assistant 972-451-0617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04785) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: TX PA04785) |
| Enumeration Date | 2008-06-08 |
| Last Update Date | 2013-09-04 |