| NPI | 1477618882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILSON Adminstrator 281-477-7490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX H8947) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |