| NPI | 1386037786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD A CARPENTER Clinic Director 830-995-3887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: TX j6289) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-08-13 |