| NPI | 1386943231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN TOMBERLIN Owner 682-518-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: TX L3703) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |