| NPI | 1629382817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTRAM W. ROBERTS Program Sponsor 210-736-4405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: TX E8143) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX K5178) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-07-30 |