NPI | 1598977290 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS O SHANNON General Manager 936-321-4345 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
Enumeration Date | 2007-05-04 |
Last Update Date | 2015-09-16 |