| NPI | 1063790038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PITTLE Owner/President 915-598-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: TX 1643) |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2024-05-01 |