| NPI | 1669945358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE LAPENOTIERE Practice Administrator 210-541-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-08 |