| NPI | 1518316447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIDIA MARTINEZ Credentialing Manager 832-742-0117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 2084P0805X |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2016-08-09 |