| NPI | 1710251921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA KAY LOWERY Credentialing Manager 469-930-3077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 367500000X Nurse Anesthetist, Certified Registered | |
| 363L00000X Nurse Practitioner | |
| 207L00000X Anesthesiology | |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2026-06-04 |