| NPI | 1942939152 |
|---|---|
| Doing Business As | PRIVIA MEDICAL GROUP NORTH TEXAS |
| Entity Type | Organization |
| Authorized Contact | LARRY D TATUM CEO 817-740-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-06-06 |