| NPI | 1558526178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DECOREY Office Manager 972-948-5316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX J8189) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |