| NPI | 1699765107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI EBERT Billing Supervisor 903-939-7774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0863040001) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2019-01-28 |