| NPI | 1447589064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOMER C REYES Owner 210-643-4255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX H2962) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H2962) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2022-06-01 |