| NPI | 1003236324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNEN LEE HEATHMAN Owner/President 281-900-3148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX 646173) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2014-04-25 |