| NPI | 1417450842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ELDER-QUINTANA Owner/Director 915-204-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M1084) |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2021-12-15 |