NPI | 1659558195 |
---|---|
Entity Type | Organization |
Authorized Contact | CONNIE L. PHAM Doctor/Owner 5128-863-5678 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0000X Family Medicine Adolescent Medicine (Licence: TX H8321) |
Enumeration Date | 2008-01-28 |
Last Update Date | 2008-01-28 |