| NPI | 1548483589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER A BIDWELL Owner 409-384-3421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX fo386) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-03-12 |