| NPI | 1255519344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E MASON Owner 817-442-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TX J4330) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |