| NPI | 1477668747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DOUGLAS MABERRY Owner 817-336-8131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX C8359) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2010-02-09 |