| NPI | 1255075362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIESKI MASTRAPA DOMINGUEZ Member 281-381-6190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2023-08-31 |