| NPI | 1356739619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VEENA BASAVA President 832-730-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2025-12-15 |