| NPI | 1629644661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE L MENDOZA Administrator 939-252-1553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 133N00000X Nutritionist |
| 152W00000X Optometrist | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |