| NPI | 1659510212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW POSEY CFO 817-551-0355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 208VP0000X |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-05-13 |