| NPI | 1053103010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE HENRY Np C 210-286-0961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 202C00000X Independent Medical Examiner |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2025-05-17 |
| Last Update Date | 2025-05-20 |