| NPI | 1508367616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLA FERMENA HEUSNER-BANKS President 361-884-2904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R0869) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-02-23 |