| NPI | 1740280403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY LYNN SKIE Owner 817-453-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: TX G5617) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2007-11-28 |