| NPI | 1164763835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIJAYABABU JAMPALA Owner 254-628-0246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2020-02-07 |