| NPI | 1376739805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DAVIDOVICH Director 817-421-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX E5103) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2007-09-18 |