| NPI | 1457539686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID VLIET CEO 512-972-4050 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: TX 552039) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-11 |