| NPI | 1639170541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARON L WINSTON Owner 512-476-3556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-07-21 |