| NPI | 1376001768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY CUBITT Member 817-658-5106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-05 |