| NPI | 1568764082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIETH L PHILLIPS Owner 214-607-3965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 1136830) |
| Enumeration Date | 2010-12-04 |
| Last Update Date | 2010-12-04 |