| NPI | 1932203197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN HARRISON Physician Clinic Support Coordinato 903-510-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 207Y00000X Otolaryngology | |
| 208800000X Urology | |
| 207X00000X Orthopaedic Surgery | |
| 208200000X Plastic Surgery | |
| 213E00000X Podiatrist | |
| 231H00000X Audiologist | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |