| NPI | 1649384991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA D WAGNER Social Worker 832-563-3237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 09909) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM2500X Clinic/Center Medical Specialty | |
| 261QF0050X Clinic/Center Family Planning, Non-Surgical | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-06-23 |