| NPI | 1164937272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE HOOVER Owner 210-737-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 130355) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |