| NPI | 1184724353 |
|---|---|
| Doing Business As | FM1960 - LAKEWOOD |
| Entity Type | Organization |
| Authorized Contact | MIRIAM COMPTON Provider Relations Rep 832-824-6602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |