| NPI | 1720031370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRI D WILSON CEO 214-691-1902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TX M0918) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: TX K3232) |
| 2088P0231X Urology Pediatric Urology (Licence: TX G9345) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2017-03-07 |