| NPI | 1972892289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE K SCOTT Manager 817-821-3568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2013-04-08 |