| NPI | 1871707331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A RUBIN Owner 318-325-1087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: LA 15728) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 15728) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-01-07 |