| NPI | 1538334461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP MARTINEZ CANTU Doctor 409-883-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX K2865) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: TX K2865) |
| 261QP2300X Clinic/Center Primary Care (Licence: TX K2865) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2013-03-25 |