| NPI | 1154788321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E HENNESSY Owner 210-422-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |