| NPI | 1730365008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS SHAW Doctor/Owner 972-548-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 613) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 613) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-29 |