| NPI | 1366047433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ROUVALDT Director Of Asc Operations 817-415-9670 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2022-06-29 |