| NPI | 1295122547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL V BODIN Director 832-962-3778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: TX 21625) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1237869) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2015-05-08 |