| NPI | 1609254135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN LEE GORE Owner 832-525-5032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX 535364) |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2015-05-17 |