| NPI | 1366879405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UME-HANEY KAKWAN Manager 979-694-3433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX L1903) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |