| NPI | 1619566205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY W EAST Owner 214-505-0833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-01-18 |