| NPI | 1518191394 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CORNELIUS DAVIS CEO 877-695-3448 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX L7349) | 
| Enumeration Date | 2009-05-08 | 
| Last Update Date | 2009-05-08 |