| 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 |