| NPI | 1265845499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCHNIKWA LAS HICKS Owner 469-734-7674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TX 139524) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |