| NPI | 1609626977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANTON PACKARD Owner 832-315-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-03-27 |