| NPI | 1023775905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE C GRIEGO CEO 915-544-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-11-26 |
| Last Update Date | 2023-03-02 |