| NPI | 1164770327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LEE DEROSSETT Insurance Manager 281-296-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX E0995) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-10-15 |