| NPI | 1437364536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M. WAGNER Managing Director 915-545-6664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine |
| 207P00000X Emergency Medicine | |
| 207PE0004X Emergency Medicine Emergency Medical Services | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2008-11-04 |