| NPI | 1588475610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA JENKINS Owner 281-861-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2025-04-29 |