| NPI | 1093010266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVETTE MERCADO Practice Manager 956-425-3706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX L2139) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L4341) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |