| NPI | 1467048975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ROBERT BENSON Sole Proprietor 512-877-5752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2023-09-06 |