| NPI | 1558526129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE MARKS Front Office 830-249-2045 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 15320) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |