| 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 |