| NPI | 1427029289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA D RAY Office Manager 361-358-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2008-03-27 |