| NPI | 1093065567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS MAYOR Ownership/Doctor 281-447-7614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX H3116) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |