| NPI | 1932334729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ANDREW LAURENCE President 817-723-8390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA04581) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-05-21 |