| NPI | 1114086659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDY GENE CORSE Dpm 936-632-5252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 0540) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 1590) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2017-11-07 |