| NPI | 1629683602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TWYLLA ALEXANDER Coding Manager 972-675-7266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2022-06-09 |