| NPI | 1326253428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M. WAGNER Managing Director 915-545-6664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics Neurodevelopmental Disabilities |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology |
| 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology | |
| 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |