| NPI | 1578956140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILL MITCHELL VP 512-495-9015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX AC01595) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-03-06 |