| NPI | 1497062830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUMAM BASSAM KAKISH Owner 469-547-1142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX K0853) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2024-07-24 |