| NPI | 1164445516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GOLLEHON Admin Assistant 210-733-4362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-04-28 |