| NPI | 1326934936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAGAN REDDY BAIRU Owner 210-788-3039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-07-21 |