| NPI | 1053641134 |
|---|---|
| Doing Business As | CHARLES MALLETT |
| Entity Type | Organization |
| Authorized Contact | CHARLES BAKER MALLETT Owner/Officer 512-441-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F1769) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2011-09-02 |