| NPI | 1558585828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL KING BLISSARD Medical Director 512-443-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F6453) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2012-01-03 |