| NPI | 1174584338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTIE R LACOUNT Admin 936-699-2798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R27244) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2012-09-18 |