NPI | 1700502150 |
---|---|
Entity Type | Organization |
Authorized Contact | COLLIN LEMAISTRE Officer/Authorized Official 469-250-3640 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2022-10-18 |
Last Update Date | 2024-10-14 |