| NPI | 1073880092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL HANSFORD KELLUM President 210-945-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J0844) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J1533) |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2015-04-07 |