| NPI | 1366628745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL ANTONIO LOPEZ President 210-845-1531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX M2695) |
| Additional Taxonomies | 207YS0012X (Licence: TX M2695) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |