| NPI | 1487301867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE BERRY Owner 210-997-8630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2023-01-31 |