| NPI | 1417310707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVARIA JABEEN Medical Director 682-777-3627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX Q2305) |
| Additional Taxonomies | 261Q00000X (Licence: TX Q2305) |
| 261QP3300X Clinic/Center, Pain (Licence: TX Q2305) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: TX Q2305) | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2016-04-03 |