| NPI | 1336734946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA BATES Owner 512-554-4523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2023-11-21 |