| NPI | 1366981607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS CHIZOMAM OKEREKE President 512-672-8797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: TX K9375) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: TX K9375) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |