| NPI | 1104599679 |
|---|---|
| Doing Business As | LAS FUENTES MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | SRIKANTH NANGAVARAM CFO 956-215-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-07-29 |