| NPI | 1366840043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LENZ Owener 956-466-1931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX J7553) |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2016-09-12 |