| NPI | 1003175423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PAUL KOZMINSKI Owner 254-634-6999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P1467) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |