| NPI | 1154638922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA EVETTE WILLOUGHBY Nurse Practitioner 832-526-4827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX 651038) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |