| NPI | 1275399206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY HENRY Owner 832-837-3620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-10-23 |