| NPI | 1073265104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRES D BOADELLA Owner 915-577-0455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-25 |