| NPI | 1881850295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECE J PANNELL Office Manager 817-294-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX 648218) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2011-06-17 |