| NPI | 1164813937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO AVILA Owner 361-500-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 677470000) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2022-01-04 |