| NPI | 1235498494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHAGVAN MALLADI Owner 936-634-3713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-06-07 |