| NPI | 1639129331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID CALVIN CEO 512-994-1933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-05-12 |