| NPI | 1104797406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DEMATTIA Owner 281-384-8455 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| 2251P0200X Physical Therapist, Pediatrics | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 111N00000X Chiropractor | |
| 225100000X Physical Therapist | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2026-02-19 |