| NPI | 1053442962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON LEE CASEY Vice President 512-301-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |