NPI | 1578077871 |
---|---|
Entity Type | Organization |
Authorized Contact | OFFICE CREDENTIALIN Credentialing Officer 832-623-5583 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: TX J3003) |
Enumeration Date | 2017-11-22 |
Last Update Date | 2023-03-30 |