| NPI | 1639446891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES A ILIYA President 214-321-2481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX G5202) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX G5202) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2016-08-20 |