| NPI | 1124233036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE D VERA Director Of Credentialing 832-295-0921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX K7693) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-01-29 |