| NPI | 1578309134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJIBOLA FAT-ANTHONY Manager 956-215-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |