| NPI | 1841543097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTA U. IKHISEMOJIE CEO 972-642-5855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX P1462) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P1462) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-11-02 |