| NPI | 1043379597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DEANN ANDERSON Billing & Collections 936-275-9910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K1721) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-11-08 |