| NPI | 1629734371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ZAPATA Administrator 214-914-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM |
| 207Q00000X Family Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2022-10-25 |