| NPI | 1518497379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT IRVINE Owner 254-245-9175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-03-24 |