| NPI | 1962481481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA VIONA LARA Practice Administrator 903-957-0470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2022-11-05 |