Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Jun 15, 2013
License(s)
FE203670 (OR), MT204740 (PA), T3574 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 844658 | Dallas, TX 75284-4658 | 254-724-2111 |
| LOCATION | 2401 S 31ST ST | Temple, TX 76508-3009 | 254-724-2663 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.