| NPI | 1366812760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK OKOSUN Medical Director 979-266-9776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX P7174) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |