| NPI | 1245541739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JEROME WILKERSON Owner 817-310-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX K9455) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2011-06-01 |