| NPI | 1700717543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KEITH HAGSTROM Physician/Owner 806-438-4452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2026-05-28 |
| Last Update Date | 2026-05-28 |