| NPI | 1609396928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PAINTER CHUDLEIGH Owner 512-699-8819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX F1450) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-07-21 |