| NPI | 1457108771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS M COOMBS Manager 972-566-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2025-09-17 |