| NPI | 1306646286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PREMETZ VP Revenue Cycle Operations 281-302-9682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-18 |