| NPI | 1457623522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH BURGE MCCOLLUM Owner 806-457-9107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX J8313) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2020-09-01 |