| NPI | 1497936959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA AYERS Admin Assistant 915-842-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2007-11-26 |