| NPI | 1386112290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MRUGESHKUMAR SHAH Provider 214-520-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |