| NPI | 1992761936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY V WHITE Administrator 972-772-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: TX 008115) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-08-22 |