| NPI | 1386310621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY SPEEDLIN GONZALEZ Owner 830-377-0713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2022-02-25 |