| NPI | 1184742256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY MARTINEZ Administrator 915-225-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |