| NPI | 1093158289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT LAROQUE President 210-566-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2013-04-08 |