| NPI | 1568573525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME BONILLA Adm 713-802-9188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: TX 0j63x) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 10580) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-06-03 |