| NPI | 1902259385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK C VALENTE Manager 972-707-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-25 |