| NPI | 1306368436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN E ALEXANDER Certified Pediatric Nurse Practitio 409-983-1882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP103698) |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2022-07-21 |