| NPI | 1023236957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA VINICE BOLTON BRUNING President 936-327-3843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX k5464) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |