| NPI | 1265971105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN J SOWERWINE Cmo 979-221-1398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207P00000X Emergency Medicine | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2024-03-15 |