| NPI | 1407851090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI KOETTER Business Office Manager 940-761-9034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 008194) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2020-08-22 |