| NPI | 1831525112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN LEMAISTRE Officer/Authorized Official 469-250-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2024-09-10 |