| NPI | 1457783953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANTON PACKARD CEO/Medical Director (Owner) 281-606-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX J6641) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J6641) |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-28 |