| NPI | 1679557888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL TREVINO CEO 409-899-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: TX 000444) |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2022-10-19 |