| NPI | 1184817736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESAUSSURE TREVINO Administrator 956-686-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX c4798) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2010-02-04 |