| NPI | 1962477091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI G. MITCHELL Business Manager 214-456-8834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX L6306) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-08-22 |