| NPI | 1689695959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB JACKSON MOORE President/Medical Director 361-888-4288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 000147) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-09-02 |