| NPI | 1003194523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRODSKY Executive Director 712-443-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX H8180) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2011-08-02 |