| NPI | 1356579924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY LAKE Administrator 214-350-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: TX 008323) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2009-06-23 |