| NPI | 1063870012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM OLSAN Owner 281-292-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2018-09-14 |