| NPI | 1902036239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA MEASHELL SNELL Surgical Assistant Certified 817-501-1375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2014-01-06 |