| NPI | 1144724261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE TRAVIS Pediatrician 512-255-8868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2024-03-19 |