| NPI | 1699054270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE M. ATWOOD Billing Supervisor 281-741-1520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: M6030) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2015-11-06 |