| NPI | 1528641362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY CHANTELL CAWTHORN Owner 210-385-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine | |
| 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine | |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |