| NPI | 1528425279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M CORREIA President 512-388-3880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 6655) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-01-26 |