| NPI | 1447535471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS CARDENAS BALANDRANO Owner 956-784-1422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX PENDING) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2012-01-09 |