| NPI | 1215451570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARLA FANNIN Practice Administrator 972-539-8488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2022-07-21 |