| NPI | 1972063527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA HERNANDEZ Manager 469-296-9912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-03-20 |