| NPI | 1639576903 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MSONTHI B LEVINE Owner 409-347-3621 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX K8650) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP125323) | 
| Enumeration Date | 2014-12-02 | 
| Last Update Date | 2014-12-02 |