| NPI | 1548446867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSA JERNIGAN Office Manager 915-541-1225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX L1894) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX E4959) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-03-28 |