| NPI | 1124204656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIE ELLIS Business Office Supervisor 832-201-5157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |