| NPI | 1376546721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE L NEAL Secretary 469-214-0144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1161) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-02-05 |