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 |