| NPI | 1235514704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL FREDERICK Md/Owner 512-485-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2024-02-05 |