NPI | 1053853663 |
---|---|
Entity Type | Organization |
Authorized Contact | KARA GOODSPEED Owner 210-827-1218 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP115987) |
Enumeration Date | 2016-11-14 |
Last Update Date | 2016-11-14 |