| NPI | 1487173357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANISHA MAHADEV DESAI Organization Owner/Proprieter 432-580-0985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX K6561) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2017-09-12 |