| NPI | 1649660168 |
|---|---|
| Doing Business As | SOUTHLAKE PAIN AND SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | KIM SIVARAMAN Billing Manager 214-618-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 130212) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-11 |