NPI | 1598996894 |
---|---|
Entity Type | Organization |
Authorized Contact | JENETHA D MORAN Authorized Official 972-763-3893 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OCS4020) |
Enumeration Date | 2009-08-04 |
Last Update Date | 2018-07-09 |