| NPI | 1740425206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WILLIAM STEPHENS President/Owner 817-461-1693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX E5950) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX None) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2011-02-11 |