| NPI | 1942994876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY CUBITT President & Owner 817-658-5106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |