| NPI | 1790492734 |
|---|---|
| Doing Business As | SEA BASE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JOHN KEVIN PAGE Owner 817-366-9772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2024-03-20 |