| NPI | 1417351123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANAEL MCGREW Owner 936-242-9501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TX 0000000) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |