| NPI | 1417372624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD ALLEN CARPENTER Clinical Manager 830-816-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 208100000X Physical Medicine & Rehabilitation | |
| 332900000X Non-Pharmacy Dispensing Site | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2015-08-18 |