| NPI | 1366517088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FEDERICO VALDERRAMA-BAZAN President 409-839-4757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E3488) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2010-09-24 |