| NPI | 1174834659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERSON THAYER MILEY Owner 512-617-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 103329) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX N5870) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX N5870) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-11-15 |