| NPI | 1649512294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY WALLS Manager 972-234-4740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 130152) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-08-01 |