| NPI | 1326328592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMIAN OKPAKO IDJAGBORO CEO 832-366-5980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03357) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2011-08-19 |