| NPI | 1245787910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE ZIMMER Credentialing Specialist 956-365-3430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 363A00000X Physician Assistant | |
| 207Q00000X Family Medicine (Licence: TX P0857) | |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2016-09-09 |