| NPI | 1548632904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOS COROVESSIS Manager 281-398-2140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX L4894) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: TX L4894) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |