| NPI | 1194491613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DAVEY CEO 512-657-1089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-10-13 |