| NPI | 1326770967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LEE CARMACK Owner 409-550-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2023-01-12 |