| NPI | 1285137182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DICKERSON Provider 214-520-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 207Q00000X Family Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |