| NPI | 1285452458 |
|---|---|
| Other Name | MOLDCO |
| Entity Type | Organization |
| Authorized Contact | ARIANA THACKER Authorized Official 512-789-7580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LF0000X Nurse Practitioner, Family | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2024-09-27 |