| NPI | 1265460919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GALE WOODROME Owner 936-327-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: TX L1499) |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-10-19 |