| NPI | 1124578018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON WIESENTHAL Physician 210-831-6367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX P3099) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |