| NPI | 1447764873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW CLAVENNA Manager 214-378-3310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 364SM0705X Clinical Nurse Specialist, Medical-Surgical |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2023-09-07 |