| NPI | 1386199354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS O SHANNON Medical Director 936-321-4345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2016-08-19 |