| NPI | 1629391842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BAGWELL Director Of Clinic Operations 210-615-5541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2023-08-24 |