| NPI | 1215473970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIAA ZORA President 936-291-9021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 25277) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 25277) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |