| NPI | 1396511820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIOLA YASIRA BOTLER IZAGUIRRE Manager 832-466-5534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QV0200X Clinic/Center, VA |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |