| NPI | 1649303488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODOLFO ALBERTO HERRERA Owner 972-436-7531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-03-25 |