| NPI | 1366642100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICIO ERNESTO JIMENEZ Owner/Physician 915-532-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX J9720) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |