| NPI | 1043615263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GHEORGHE PUSTA CEO 512-628-0465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX Q1815) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX Q1815) |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2023-07-21 |