| NPI | 1407106271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J A COFFEY Owner 940-381-0885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX H0254) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |