| NPI | 1588073001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENE HENRY Owner 979-696-5883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX G5165) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2014-08-08 |