| NPI | 1174106371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY ONONYE Provider 832-331-6255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |