| NPI | 1417150731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO DENNIS O'GORMAN Director 979-864-1484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |