| NPI | 1669984498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CAMPBELL Claims Analyst 512-948-1752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0002X Clinic/Center Emergency Care |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2022-12-15 |