| NPI | 1225066277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE FUCIARELLI Vice President For Finance And Admi 915-215-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 1223P0106X Dentist Oral and Maxillofacial Pathology |
| 152W00000X Optometrist | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-10-21 |