| NPI | 1508410846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODOLFO A HERRERA Medical Director 972-436-7531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QS0010X Family Medicine Sports Medicine | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2020-03-12 |