| NPI | 1265858492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY RAMON Administrator 210-481-9544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX J5769) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX K2111) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX m8988) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2020-10-20 |