| NPI | 1497708408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID S JENSON Physician 936-273-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 1637) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2009-02-04 |