| NPI | 1245520683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY GBENGA FADIPE Program Manager 832-875-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation (Licence: TX 261QM0801) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2011-05-25 |