NPI | 1629531488 |
---|---|
Entity Type | Organization |
Authorized Contact | JENETHA MORAN Authorized Official 972-763-3893 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2019-04-09 |
Last Update Date | 2019-04-09 |