| NPI | 1801146758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD STEPHENS Owner/President 940-627-6201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX L3143) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX L3143) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |