| NPI | 1467104307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAMAWAH I BOURQUE Physical Therapist 832-512-8722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-01-21 |