| NPI | 1689188823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN LEMAISTRE Officer/Authorized Official 214-213-0732 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2024-09-13 |