| NPI | 1144472911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHIA BOYD Credential Specialist 210-293-2753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: UT 354030-3102) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2008-10-10 |