| NPI | 1639061609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERIC DEMOND OUTLEY Manager 713-498-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 101YP2500X Counselor, Professional | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2025-07-16 |
| Last Update Date | 2025-11-28 |