| NPI | 1386447183 |
|---|---|
| Doing Business As | XXX-XX-XXXX |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DANIEL CORRALES Physician/Director 713-703-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-07-16 |