| NPI | 1174216121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HATTIE ELAINE HENDERSON Physician Owner 281-217-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2023-05-26 |