| NPI | 1104253962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESPIRIDION MENDEZ Vice President 512-595-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA05410) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX G3628) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2015-06-24 |