| NPI | 1699458802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LEE Manager 817-284-9850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2025-06-02 |