| NPI | 1942748793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA DRERUP Vice President Of Operations 817-875-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |