| NPI | 1629951397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KISHORE RASAMALLU Md/Owner 210-379-8553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-07-29 |
| Last Update Date | 2025-07-29 |