| NPI | 1558764431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER JAIMES Billing/Credentialing Manager 972-270-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX SA00036) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2014-10-06 |