| NPI | 1033079199 |
|---|---|
| Doing Business As | MEN'S DIVISION |
| Doing Business As | WOMEN'S DIVISION |
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROACH Owner/Provider 281-900-0597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-11-12 |
| Last Update Date | 2025-11-12 |