| NPI | 1285912931 |
|---|---|
| Doing Business As | SOUTHWEST SPORTS AND SPINE CENTER |
| Entity Type | Organization |
| Authorized Contact | WILLIAM JOHNSON Director Of Operations 817-920-3887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208VP0000X | |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2011-07-29 |