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 |