| NPI | 1609297902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE AGUIRRE COO 512-301-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H3680) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03274) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2014-01-03 |