| NPI | 1861753733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR GONZALEZ Member 972-596-3018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX M4104) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07507) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-08 |