| NPI | 1417213265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA DESHUN ALLEN Self 832-767-2357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX M1464) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2012-04-10 |