| NPI | 1821573650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR RAKOVCHIK Provider 214-221-2580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2020-09-24 |