| NPI | 1215196142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS PORTO President 806-771-1386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H4621) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX H4621) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2009-06-05 |