| NPI | 1508146622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO A. QUINTANILLA Md 361-993-4793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX F1201) |
| Enumeration Date | 2011-08-20 |
| Last Update Date | 2011-08-20 |