| NPI | 1497600118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RYAN NORTHCUTT Owner 817-454-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2026-02-27 |
| Last Update Date | 2026-02-27 |