| NPI | 1215042189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ALEXANDER CANNON President 210-650-9066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L8002) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2017-04-05 |