| NPI | 1245387240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT SLOAN Manager 469-458-3872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TX G5619) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G5619) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-11-02 |