| NPI | 1457632440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA GREGORY N/A 936-760-2784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: TX BZ3718105) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J4636) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2022-06-20 |