| NPI | 1164432175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CUELLAR Practice Owner 636-327-6556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 431914596) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |