| NPI | 1497130751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC OMAR ANSARI Managing Member 832-930-1366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD452657) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-08-13 |