| NPI | 1568740892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ANDERSON Owner 817-810-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2022-06-09 |