| NPI | 1548263346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH IVY Practice Manager 210-450-5840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX 00U97M) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX 00U97M) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: TX 00U97M) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX 00U97M) | |
| 208600000X Surgery (Licence: TX 00U97M) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-07-18 |