| NPI | 1578649570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY TYDLASKA President 817-294-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 052014) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |