| NPI | 1609298934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE AGUIRRE COO 512-301-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H3680) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03274) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |