| NPI | 1104684810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS R REPP Owner 512-633-4997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083B0002X Preventive Medicine Obesity Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-03-07 |