| NPI | 1952853152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA BOUDREAUX VP Operations 469-422-0641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX q9070) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2019-02-07 |