| NPI | 1235707332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE PATRIDGE Coder Biller 972-412-5299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204R00000X Electrodiagnostic Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2022-09-27 |