| NPI | 1245578459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNA LAROQUE Director Of Client Experience 210-598-4277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2022-08-31 |