| NPI | 1689779035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA BAILEY Office Manager 972-702-9310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX G8700) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX K2530) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX D2622) | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: TX D0260) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |