| NPI | 1245339522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE LASKOSKIE Credentialing Coordinator 281-392-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX J2958) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX L3640) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-11-14 |