| NPI | 1285509620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ROUVALDT Sr. Director Of Asc Compliance 817-893-2381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |