| NPI | 1619455789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN PEDRO Owner 817-336-0661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX D7240) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |