| NPI | 1518742774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WILLIAMS COO 512-294-5178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-30 |