| NPI | 1255875126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DAVIDSON Clinical Administrator 936-441-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2021-06-14 |