| NPI | 1609108059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE GONZALEZ Medical Coordinator 512-892-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 1180810) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 16480) |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2010-02-10 |