| NPI | 1487077111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROOSEVELT GILMORE Chief Executive Officer 817-526-2882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX G37993) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-01-31 |