| NPI | 1265554000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE L. CLARK ,Office Manager 936-639-6210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX G4729) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-10-29 |