| NPI | 1619726056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS WADLINGTON Vice President 972-401-9807 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-05-17 |