| NPI | 1962606616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY KYLE BUTH Business Manager 817-731-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX K8811) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2008-04-07 |