| NPI | 1750934089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK GOVE Administrator 972-740-7908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207L00000X Anesthesiology | |
| 207LP2900X Anesthesiology Pain Medicine | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207T00000X Neurological Surgery | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2023-05-16 |