| NPI | 1295716264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN ALLEN GUETLEIN Administrator 325-223-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 008075) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2020-08-22 |