| NPI | 1679804355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIPS KIRK LABOR Md/Owner 817-410-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 130049) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2020-06-22 |