| NPI | 1518385681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH WICHMAN Medical Director 210-458-4135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX H7845) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-04-04 |