| NPI | 1275930216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA DANNA Officer / Authorized Official 972-763-3890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2021-09-08 |