| NPI | 1013307107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD A. JACKSON Owner 713-400-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX D8289) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |