| NPI | 1902216294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BRYAN Owner 972-492-4006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2021-01-19 |