| NPI | 1053613216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGOCPHUONG THI TRAN President 512-873-7174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX OOH46M) |
| Enumeration Date | 2010-11-21 |
| Last Update Date | 2015-08-26 |