| NPI | 1639472749 |
|---|---|
| Doing Business As | DOING BUSINESS AS |
| Entity Type | Organization |
| Authorized Contact | TINA V GOMEZ Credentialing 210-614-3335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX D7379) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2011-04-12 |