| NPI | 1386188514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICA MALEIGH WYNN VELA Nurse Practitioner/ Owner 832-724-4283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP122501) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |