| NPI | 1619993276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES STEVEN FEHLAUER Owner 888-700-6907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: UT 294016-2401) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2026-03-27 |