| NPI | 1982119061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY BUFORD Practice Administrator 936-648-6975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX L1655) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2021-04-23 |