| NPI | 1225329584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH BARBARA HENDERSON Owner/Manager 817-705-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: TX N4467) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |