| NPI | 1265723472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN VAN DIEST Owner 325-675-0338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: TX M7978) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |