| NPI | 1841442233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE R. KIRKHAM Health Care Provider 972-566-7515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX E7636) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2009-04-06 |