| NPI | 1770138851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUETTA JACKSON Owner 214-227-2457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2022-10-03 |