| NPI | 1306478417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK T MITCHELL Owner, Authorized Official 972-920-6968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |