| NPI | 1619538089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JAMES BONNET General Manager 210-800-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 103T00000X Psychologist | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |