| NPI | 1164597852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY HAYNES Billing And Coding Specialist 210-207-8689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2023-01-03 |