| NPI | 1437826211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTICE OTCHERE Medical Director 682-433-9287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2021-08-27 |