| NPI | 1114755642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE ASHLEIGH BOEHM Clinic Manager 361-571-7956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-07-25 |