| NPI | 1285978098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KEITH PRESTON Owner 972-377-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07007) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07772) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA06349) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA05731) | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |