| NPI | 1548909930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT P PALUSSEK COO 409-242-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2025-01-08 |