| NPI | 1972045243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGH ANN CADENHEAD Administrator 469-898-8402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2023-10-05 |