| NPI | 1619409141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDON ROUSSEL Owner 713-703-9910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA MD.207273) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |