| NPI | 1053723239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRA PEACOCK Office Manager 210-651-3233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX K8022) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2023-12-20 |