| NPI | 1326114869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENETHA D MORAN Officer/Authorized Official 972-763-3893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 008549) |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2017-07-25 |