| NPI | 1235332933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENETHA D MORAN Officer / Authorized Official 972-763-3893 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2018-03-29 |