| NPI | 1710028295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE L ANDERSON Owner 214-420-0650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX M6002) |
| Additional Taxonomies | 207N00000X Dermatology |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2019-11-13 |