| NPI | 1457593626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI L VAUGHN Director 409-923-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX M3777) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA 023914) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2009-04-02 |