| NPI | 1851602858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL PENDLETON Director 817-400-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 1916) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2020-08-11 |