| NPI | 1104555044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDO REYES Owner 281-203-5006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-07-01 |