| NPI | 1053135657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HERNANDEZ Billing Manager 980-989-9487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2024-11-11 |