| NPI | 1902550486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MARTIN President 469-215-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| 335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2022-03-13 |