| NPI | 1518117290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LURLEAN B DIXON President/Case Manager 713-675-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 305R00000X) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2018-06-21 |