| NPI | 1972687622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M CARTER Lsa 817-294-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: TX SA00165) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |