| NPI | 1275379836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN KANE Owner 972-591-6468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-08-16 |