| NPI | 1003129891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN GRAY COO Rdinator/Nurse 409-880-8466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 618115) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-07-21 |