| NPI | 1427413723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUIZ Administrator 409-813-1677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP128428) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2022-09-21 |