| NPI | 1386770147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARA TALIA PETERSON CFO 361-886-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2024-08-04 |