| NPI | 1073935227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE LYNN LONG Owner/Np 512-343-3665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX 608462) |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |