| NPI | 1487783759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY BRUMLEY Practice Administrator 214-509-9691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX L9810) |
| Additional Taxonomies | 208VP0000X (Licence: TX F6754) |
| 208VP0000X (Licence: TX H0458) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2011-04-18 |