| NPI | 1205144029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE SEGURA Practice Manager 512-467-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2012-09-24 |