| NPI | 1902284227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY BROOKS WALLACE President 214-288-9955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX N4832) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TX N4832) |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX N4832) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |