| NPI | 1689473068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE CLEMONS VP Of Operations 972-236-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-03-10 |