| NPI | 1548070170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN SUNDAY UGWUANYI Administrator 512-947-4920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2025-01-07 |