| NPI | 1558038935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL AYALA CEO, President 832-338-0446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |