NPI | 1124247119 |
---|---|
Entity Type | Organization |
Authorized Contact | LESLIE LONGORIA Credentialing Specialist 210-268-0129 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Additional Taxonomies | 174400000X Specialist (Licence: TX j5738) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2021-04-01 |