| NPI | 1104359710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OROBOSA EMMANUEL OGHIDE Owner 979-316-3437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP126802) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2026-04-06 |