| NPI | 1639189871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A EIVENS Partner 512-258-3384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 18642) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 18720) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |