| NPI | 1689471567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LACY President 210-724-8656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-02-27 |
| Last Update Date | 2025-05-12 |