| NPI | 1588854772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENETHA MORAN Authorized Official 972-763-3893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AL U3710) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2017-07-25 |