| NPI | 1659720746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN BEALE Director 972-566-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX P2995) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX 08618) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |