NPI | 1083954853 |
---|---|
Entity Type | Organization |
Authorized Contact | MELINDA ONDRASEK Practice Administrator 512-652-0050 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: TX N9669) |
Enumeration Date | 2013-02-15 |
Last Update Date | 2013-02-15 |