| NPI | 1891166039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERAN M DAVIS Member 817-516-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |