| NPI | 1497328777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ROBERSON Cmo 210-364-8636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2021-08-09 |