NPI | 1376581900 |
---|---|
Entity Type | Organization |
Authorized Contact | SARAH I PORTER Director Of Provider Enrollment 817-451-4208 |
Organization Subpart ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-06-04 |
Last Update Date | 2020-12-28 |