| NPI | 1407256472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOBOLANLE FAGBEMI Family Nurse Practitioner 409-225-5644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX 671760) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |