| NPI | 1750383386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM HARRIS Practice Administrator 903-595-2636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX D4981) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L1987) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX D4981) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX K0862) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX H4385) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX L1987) | |
| 208C00000X Colon & Rectal Surgery (Licence: TX H4385) | |
| 208600000X Surgery (Licence: TX K0862) | |
| 208600000X Surgery (Licence: TX H4385) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2020-08-05 |