| NPI | 1558766758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MALLON CFO 956-632-6101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: TX 518243) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |