| NPI | 1366033326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE F MATA Owner 281-935-6072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2023-05-03 |