| NPI | 1952773954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL M SOTO Member Manager/President 972-392-4476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207QS0010X Family Medicine Sports Medicine | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2019-01-29 |