| NPI | 1386086411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN LEMASTRIE Officer/Authorized Official 469-250-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2021-04-12 |