| NPI | 1467942565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA WADE Owner 832-262-1299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120465) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2022-10-04 |