| NPI | 1376872978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA A NABORS Program Service Director 832-647-2859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: CA 0311434) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2009-12-10 |