| NPI | 1912746264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ROUVALDT Director Of As Cs 817-893-2381 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |