| NPI | 1578010500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE DA COSTA - PANY Nurse Practitioner 832-533-5988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131407) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |