| NPI | 1376767913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM A FADER Physician 361-994-7255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX H3035) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2013-08-29 |