| NPI | 1104160225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD MORRIS BLOCK Business Owner 915-261-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX D0802) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-12-31 |