| NPI | 1124470570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PADMA NAGALAKSHMI MUNUKUTI Md 469-518-4823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX N5269) |
| Enumeration Date | 2016-07-10 |
| Last Update Date | 2026-04-28 |