| NPI | 1669833208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTY R WILKINS Provider/Owner 210-846-4979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 680616) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2016-03-09 |