| NPI | 1609718600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN JOSEPH ELIESON Owner 817-748-2260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2026-04-08 |
| Last Update Date | 2026-04-08 |