| 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 |