| NPI | 1669506952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY RODARTE CFO 915-534-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 225100000X Physical Therapist | |
| 261Q00000X Clinic/Center (Licence: TX 193200000x) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-09-12 |