| NPI | 1568098937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MCCOY Manager 512-364-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2020-03-18 |