| NPI | 1659328870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN B LYDE Owner 972-436-0358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX H0585) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2010-07-26 |