| NPI | 1255461448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DALE REYNOLDS Doctor 915-532-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX K7875) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |