| NPI | 1003269945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GORN President 512-571-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: CA 20A14618) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-15 |