| NPI | 1174925473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ASH Director 210-519-1116 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 23023) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2019-05-21 |