NPI | 1811286875 |
---|---|
Entity Type | Organization |
Authorized Contact | VIRGINIA E SMITH Credentialing Coordinator 888-737-9615 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 26045) |
Enumeration Date | 2011-03-30 |
Last Update Date | 2011-03-30 |