| NPI | 1174841456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE DENISE GRANT Owner/Physician 512-610-7030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2019-02-12 |