| NPI | 1093320996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY WINGARD Owner 832-913-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2024-05-29 |