| NPI | 1386830800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS OSWALD SHANNON General Manager 936-321-4345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 8543) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2007-09-18 |