| NPI | 1235673633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVERESS VICKI RICKERSON Owner 210-646-7227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX AP132396) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |