| NPI | 1497099410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY L LILLY Director 210-615-7480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2016-01-14 |