| NPI | 1740306208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S WALLACE President 972-463-1253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX J3932) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |