| NPI | 1033545363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI JEAN SPARKS Owner 210-340-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX E6215) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-09-18 |