| NPI | 1316115009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW W JACKMAN Owner 903-463-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 1782) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2012-02-09 |