| NPI | 1699701870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON EUGENE COOKE President 325-672-4372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 6357380001) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 6357380001) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2010-06-01 |