| NPI | 1578008827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON TEMPLE Billing Administrator 817-655-2164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 24887) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2024-01-29 |