| NPI | 1881189132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN E MCDONALD Office Mgr 817-269-1472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: CO 180887) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |