| NPI | 1619637543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL MONTGOMERY Officer/Authorized Official 512-557-4294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2026-04-29 |