NPI | 1477169076 |
---|---|
Entity Type | Organization |
Authorized Contact | VINCENT JOSEPH MANDOLA Physician/Owner 281-485-3226 |
Organization Subpart ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
Enumeration Date | 2020-09-18 |
Last Update Date | 2021-12-22 |