| NPI | 1255294989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL KIRKLAND Enrollment Coordinator 469-893-2695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2025-12-09 |
| Last Update Date | 2025-12-09 |