| NPI | 1316123862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD COBB GROSSMAN Owner 817-251-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: TX G4587) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX G4587) |
| 207Y00000X Otolaryngology (Licence: TX G4587) | |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: TX G4587) | |
| 207YS0012X Otolaryngology Sleep Medicine (Licence: TX G4587) | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: TX G4587) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: TX G4587) | |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |