| NPI | 1407562762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY A CRUMPLER Authorized Official 281-806-9544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-01-30 |