| NPI | 1922441815 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ADRIANNA VILLARREAL Admin 214-295-6703 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical | 
| Additional Taxonomies | 207L00000X Anesthesiology | 
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2013-04-10 | 
| Last Update Date | 2013-04-10 |