NPI | 1679759245 |
---|---|
Entity Type | Organization |
Authorized Contact | MELODY C BROCKHAN Billing Specialist 281-991-0444 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX K3839) |
Enumeration Date | 2008-01-14 |
Last Update Date | 2008-03-03 |