| NPI | 1538517974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI BEAVERS Credentialing Manager 318-325-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 08006R) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-10-04 |