| NPI | 1295161313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP SWANSON President 817-424-2606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX G6237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08041) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2013-09-20 |