| NPI | 1295254241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN COLLIS VALDEZ LACY Practioner Owner 210-459-6514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV APRN002311) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2022-07-21 |