| NPI | 1649011966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL SCOTT CEO 915-248-8978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-06-03 |