NPI | 1790241073 |
---|---|
Entity Type | Organization |
Authorized Contact | COLLIN LEMAISTRE Officer / Authorized Officer 469-250-3640 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
Enumeration Date | 2019-02-12 |
Last Update Date | 2024-09-13 |