| NPI | 1588815252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARITY RENEE HEIN RN Fa 409-794-9068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 677903) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |