| NPI | 1407144132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ALEC TISDALE Chief Of Staff 210-267-1374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2011-11-21 |