| NPI | 1710218698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIPUL SHELAT Owner 318-324-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: LA 13324R) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: LA 13324R) |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: LA 13324R) | |
| Enumeration Date | 2010-01-16 |
| Last Update Date | 2010-01-16 |