| NPI | 1740531409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY HUIZAR CEO 765-838-1660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208600000X Surgery | |
| 208D00000X General Practice | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |